CAM’ s contribution to health and well being and its role alongside conventional medicine are poorly understood. The scope of application is variable and the differences between the many CAM practices are not well known. There is also significant prejudice to CAM. Practitioners have been prosecuted on legal grounds unconnected to their competence or client complaint. Published research is thin on the ground for many CAM practices, and most of what exists examines them as if they were a form of conventional medicine.Shiatsu is one of the eight disciplines named in the Collins Report adopted by the European Parliament in 1997 (European Parliament 1997) which calls for steps to regulate complementary therapy practice and for more research. Initiatives have been taken by a few member states since, but none are complete. There still has not been a specific research line for CAM in the European Union’s (EU) Framework Programs (FP) 5 to 7. The current program, FP7, may provide funding for ‘translating clinical outcomes into clinical practice, especially addressing patient safety and the better use of medicines (including some aspects of … complementary and alternative medicine).’ (European Union 2006: 12)

Shiatsu has been practiced professionally in Europe for 35 years. While common law allows it to be practiced freely in the UK and Ireland, its practice in the rest of Europe, along with most other CAM methods, is tolerated, but without recognition as an independent discipline, or integration into state healthcare systems. This uncertainty has acted as a brake on the progress of shiatsu, its professional development, and its use by the public. In the official imagination, in so far as shiatsu exists there at all, it rests somewhere between the harmless, the useless or dangerous quackery.

In Japan, where shiatsu originated, it has been an officially recognized paramedical practice since 1952. In Europe, it is popular with the public but, until now, there has been no objective evidence for its safety, extensive data on who uses it and why, or an assessment of its benefits. The European Shiatsu Federation, in working to gain the legal ‘right to practice’ shiatsu throughout Europe and to promote the highest standards of training and professional practice, saw the need for evidence independent of the profession’s view.

The development of the study design took particular account of the fact that shiatsu practice occurs within the energetic relationship between the practitioner and the client, that it is intuitive in its nature, and that it is broad in its guiding philosophy and scope of application. The findings summarized below speak volumes about this ancient art. They validate an intuitive but practical system with contemporary and rational tools, bridging longstanding cultural gaps. Not surprisingly, the findings suggest the need for more research. These findings are now offered in service to the public, the profession, researchers, policy makers and health care providers.

This study followed up on a cohort of 984 clients receiving shiatsu in three countries (Spain, Germany and the UK). The study sought to look at clients’ long-term experiences and effects of receiving shiatsu as well as finding out about the practitioners and their style of practice.

The key policy findings:

Confirm the safety of shiatsu as practised within the three countries

Demonstrate interconnected and consistent evidence of client perceived beneficial effects in the short and longer term. These range from symptom change to lifestyle changes. The effects are maintained in the longer term (six months follow-up)

Benefits in terms of general well-being, health maintenance, health promotion (uptake of advice and recommendations) and health awareness are notable. This suggests a potential role for shiatsu in public health

Findings on a reduction in use of conventional medicine, medication and working days lost due to ill-health are indicative of an added value and potential economic benefit arising from shiatsu treatment